Using the Cholinergic Anti-Inflammatory Pathway to Treat Systemic Lupus Musculoskeletal Pain

Exclusion Criteria

• •1. Treatment with rituximab within one year of baseline (subjects with previous treatment with rituximab can enter study only with documentation of B cell repletion),
• •2. Treatment with cyclophosphamide within 2 months of baseline,
• •3. Expectation to increase steroids and/or immunosuppressive treatment,
• •4. Anti-phospholipid syndrome,
• •5. Fibromyalgia (fibromyalgia will be defined as a score \> 13 on the Fibromyalgia Symptom Scale (FSS).
• •6. Treatment with an anti-cholinergic medication, including over the counter medications,
• •7. Implantable electronic devices such as pacemakers, defibrillators, hearing aids, cochlear implants or deep brain stimulators.
• •8. Current tobacco or nicotine user,
• •9. Joint replacement within 60 days prior to study enrollment or planned within the course of the study,
• •10. Any planned surgical procedure requiring general anesthesia within the course of the study,
• •11. Intra-articular cortisone injections within 28 days of the start of study,
• •12. Chronic inflammatory disorders apart from SLE affecting the joints,
• •13. Investigational drug and/or treatment during the 28 days or seven half-lives of the investigational drug prior to the start of study drug dosing (Day 0), whichever is the greater length of time,
• •14. Active infection including hepatitis B or hepatitis C at baseline,
• •15. Any condition which, in the opinion of the investigator, would jeopardize the subject's safety following exposure to a study intervention,
• •16. Pregnancy or lactation,
• •17. Comorbid disease that may require administration of corticosteroid use,
• •18. Inability to comply with study and follow-up procedures.